Ms. O is a 28-year-old woman married for 3 years who has just returned from an outdoor camping trip with her husband, with symptoms of dysuria with a burning sensation, urgency to urinate, and frequent urination.
She said, “I have had similar symptoms three times over the last 2 years.
Pubic and low back discomfort awoke me two nights ago and that is why I am here.”
On physical examination, her temperature was 98.6° F, blood pressure was 114/64mm Hg, pulse was 68 beats per minute, and the respiratory rate was 12 breaths per minute.
Other than a tender abdominal pelvic area, the examination was unremarkable.
Initial differential diagnosis were; UTI, pyelonephritis, vaginitis, urethritis, interstitial cystitis.
I think that below to continue we may be looking at E. Coli possibly, would that be correct?
Question A)
Notable laboratory results from a dipstick urinalysis, microscopic examination, and urine culture:
Color was dark yellow; trace blood; no casts; bacteria, especially E. coli, and WBCs were too numerous to count.
Given the following laboratory results, what is her final diagnosis and treatment?
When looking at the urine what is the significance of the yellow color?
What is the significance of the presence or absence of casts?
Question B)
What are the likely bacterial culprits?
When looking at the bacterial culprits are any particularly significant in the sense that it might be resistant to some of the antibiotics that E Coli would be susceptible to?

Solution

As per symptoms (dysuria with a burning sensation, frequent urination, pubic and low back pain) and laboratory results (blood in urine, E.Coli, presence of WBC in urine) diagnose the urinary tract infection or kidney infections (pyelonephritis). The blood is observed in urine is called hematuria caused by kidney infection by bacteria which is Escherichia coli (E.Coli) a type of bacteria commonly found in the gastrointestinal (GI) tract. Usually hematuria is more common in women with bacterial infection of the bladder (cystitis). Sexual intercourse may lead to cystitis, and women are at risk of cystitis because of their anatomy specifically, the short distance from the urethra to the anus and the urethral opening to the bladder....

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